原发性肝癌患者血清AFP、AFP-L3、PIVKA-Ⅱ水平及与病理特征和预后的关系分析  

Analysis of serum AFP,AFP-L3,PIVKA-Ⅱlevels and their relationship with pathological features and prognosis in patients with primary hepatocellular carcinoma

作　　者：罗铎 欧志涛[2] 黄韫 陈彬彬[3] 杨可立[3] 李康保[1] LUO Duo;OU Zhi-tao;HUANG Yun;CHEN Bin-bin;YANG Ke-li;LI Kang-bao(Department of Geriatrics,Guangzhou First People’s Hospital,School of medicine,South China,University of Technology,Guangzhou 510180,China;Department of Gastroenterology,Guangzhou Eighth People’s Hospital,Guangzhou 510060,China;Department of Hepatology,Guangzhou Eighth People’s Hospital,Guangzhou 510060,China)

机构地区：[1]广州市第一人民医院老年病科,510180 [2]广州市第八人民医院嘉禾院区消化内科,510440 [3]广州市第八人民医院东风院区肝病科,510060

出　　处：《现代消化及介入诊疗》2022年第2期140-143,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：广东省医学科学技术研究基金项目(A2019296)。

摘　　要：目的探讨原发性肝癌(HCC)患者血清AFP(甲胎蛋白)、AFP异质体(AFP-L3)、PIVKA-Ⅱ(异常凝血酶原)水平和病理特征、预后间的联系。方法将85名HCC患者归入研究组,70名同期体检的健康志愿者归入对照组。检测两组入组对象血清AFP、AFP-L3与PIVKA-Ⅱ水平,并对研究组不同分期和分化程度患者血清AFP、AFP-L3、PIVKA-Ⅱ水平进行比较,采用Kaplan-Meier法完成生存曲线的制作,对血清AFP、AFP-L3与PIVKA-Ⅱ水平影响HCC病人预后状况展开评估。结果研究组血清AFP、AFP-L3与PIVKA-Ⅱ水平均显著高于对照组(P<0.05)。研究组Ⅲ~Ⅳ期患者血清AFP、AFP-L3、PIVKA-Ⅱ水平高于Ⅰ~Ⅱ期患者(P均<0.05);研究组低分化程度患者血清AFP、AFP-L3、PIVKA-Ⅱ水平均明显高于中、高分化程度患者(P均<0.05);中分化程度患者血清AFP、AFP-L3、PIVKA-Ⅱ水平高于高分化程度患者(P<0.05);AFP、AFP-L3与PIVKA-Ⅱ高表达患者生存率较低表达患者明显降低(P均<0.05)。结论原发性肝癌患者血清AFP、AFP-L3、PIVKA-Ⅱ水平与临床分期、分化程度及预后密切相关,提示AFP、AFP-L3、PIVKA-Ⅱ水平可作为评估原发性肝癌患者病情进展程度及不良预后的生物学指标。Objective To analyze the serum alpha-fetoprotein(AFP),alpha-fetoprotein-L3(AFP-L3)and protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ)levels in patients with primary hepatocellular carcinoma(HCC)and their relationship with pathological features and prognosis.Methods Eighty-five patients with primary liver cancer were selected as the research group,and 70 healthy volunteers who received physical examination during the same period were selected as the control group.The serum AFP,AFP-L3 and PIVKA-Ⅱlevels of patients in the two groups were detected and analyzed,and the serum AFP,AFP-L3 and PIVKA-Ⅱlevels of patients with different stages and degrees of differentiation in the study group were compared.Kaplan-meier method was used to draw survival curve to evaluate the effect of serum AFP,AFP-L3 and PIVKA-Ⅱlevels on the prognosis of patients with primary liver cancer.Results The levels of Serum AFP,AFP-L3 and PIVKA-Ⅱin the study group were higher than those in the control group(P<0.05).The levels of AFP,AFP-L3 and PIVKA-Ⅱin patients with stageⅢtoⅣwere higher than those in stage I toⅡ(P<0.05).Serum AFP,AFP-L3 and PIVKA-Ⅱlevels in patients with low differentiation were significantly higher than those in patients with medium and high differentiation(P<0.05).The levels of AFP,AFP-L3 and PIVKA-Ⅱin patients with intermediate differentiation were higher than those in patients with high differentiation(P<0.05).The survival rate of patients with high expression of AFP,AFP-L3 and PIVKA-Ⅱwas lower than that of patients with low expression(ALL P<0.05).Conclusion Serum AFP,AFP-L3 and PIVKA-Ⅱlevels in patients with primary liver cancer are closely related to clinical stage,degree of differentiation and prognosis,suggesting that AFP,AFP-L3 and PIVKA-Ⅱlevels can be used as biological indicators to evaluate the degree of disease progression and poor prognosis in patients with primary liver cancer.

关 键 词：原发性肝癌 甲胎蛋白 甲胎蛋白异质体 异常凝血酶原 病理特征 预后 

分 类 号：R735.7[医药卫生—肿瘤] R575[医药卫生—临床医学]